068 [Ask Inna] Answers to All Your Hashimoto’s Questions

07/16/20 • 23 min

Thyroid Mystery Solved: Hashimoto's and Hypothyroidism Revealed

I asked what you wanted to know about Hashimoto’s and the questions came flying in! In this episode, I’m going to tackle half of them and tune in next week as well because I’ll answer the rest there!

Hashimoto’s disease is an autoimmune disease that affects the thyroid. Like other autoimmune diseases, what happens is that the immune system gets confused and starts to see the thyroid as a threat. In other autoimmune diseases, the system attacks a different part of the body (the myelin sheath with MS, joints with rheumatoid arthritis, connective tissue with lupus). Under this attack, the thyroid can’t perform optimally and the result is often hypothyroidism.

Conventional medicine treats Hashimoto’s by only addressing the hypothyroidism if present or waiting for hypothyroidism to begin or suppressing the immune system with medication. The functional medicine approach is to find the root cause of the Hashimoto’s and fix it. I support the functional medicine approach and it starts by understanding what’s going on first. Which is why, I’m so happy to answer your questions!

Autoimmune Triggers

There are four main triggers that can get the immune system in a tizzy. Here are the key triggers for autoimmune diseases:

Food

Individuals may have food sensitivities, or lack the proper enzymes or stomach bile to properly digest food. If the food we eat doesn't work for our body its a huge trigger for autoimmunity.

Infection

There are a variety of infections that can become chronic causing the immune system to malfunction.

Toxins

Environmental toxins (like those found in some cleaning products and beauty products) as well as heavy metals can serve as a trigger.

Stress

The immune system handles stress by shutting down other non-essential systems. Over time (especially if it’s chronic), this can be a trigger for autoimmune disease.

Question #1: What is the relationship between heavy metals and the root cause of Hashimoto's?

Heavy metals are things like aluminum, mercury, arsenic, lead and they can really do a number on our system. Our bodies can handle a little bit of heavy metals but when they build up, they become a toxin (which is one of the triggers). Even copper can become a toxin if it gets out of control (usually due to a zinc deficiency). Mercury has an affinity for the thyroid, so this heavy metal (in particular) should be monitored to ensure it hasn’t reached toxic levels in the body.

There are lab tests that will determine if heavy metals might be the root cause for you. A standard hair analysis is one test but it doesn’t show both types of mercury. My go-to tests for heavy metal are the Quicksilver Scientific Tests because it includes a full heavy metal panel and looks for mercury levels in the blood, urine, and hair.

If heavy metal is a problem, then a detox using binders and herbs like Milk Thistle are often used. However, you’d want to consult with a functional medicine practitioner to make sure you’re doing the right kind of cleanse.

Question #2: What is the connection between Hashimoto’s and the adrenal glands?

Stress is one of the four triggers. The adrenal glands deal with stress by producing the hormone cortisol. When too much is produced, the immune system takes that to mean that it’s an emergency putting things like thyroid production on the backburner.

Cortisol also has a relationship with TSH. When cortisol is off, TSH can be off as well and directly affect thyroid function. There is one other potential connection. The symptoms of hypothyroidism are very similar to the symptoms of adrenal fatigue (weight gain, fatigue, depression, hair loss) and so the symptoms may be misinterpreted.

Question #3: What is the true connection to EBV (Epstein-Barr Virus)?

This question sparked a secondary question involving the Medical Medium and the things he’s said about EBV being connected to everything, including attacking the thyroid before causing Hashimoto’s.

I get asked about this a lot but remember the four triggers - one of them is infection which is exactly what EBV is. There is some research that EBV can get into the thyroid gland (as well as other organs) but I wouldn’t say it’s conclusively linked. However, it is an infection which is a trigger. It’s worth noting that once someone gets EBV it’s always in the system and it can flare up due to stress, toxins, and other infections - it has the same triggers as autoimmune.

Question #4: Can you Address Food Sensitivities with Hashimoto’s?

Another listener also asked about her experiences with cutting out gluten and dairy and subsequently developed other food sensit...

Autoimmune Triggers

There are four main triggers that can get the immune system in a tizzy. Here are the key triggers for autoimmune diseases:

Food

Individuals may have food sensitivities, or lack the proper enzymes or stomach bile to properly digest food. If the food we eat doesn't work for our body its a huge trigger for autoimmunity.

Infection

There are a variety of infections that can become chronic causing the immune system to malfunction.

Toxins

Environmental toxins (like those found in some cleaning products and beauty products) as well as heavy metals can serve as a trigger.

Stress

The immune system handles stress by shutting down other non-essential systems. Over time (especially if it’s chronic), this can be a trigger for autoimmune disease.

Question #1: What is the relationship between heavy metals and the root cause of Hashimoto's?

Question #2: What is the connection between Hashimoto’s and the adrenal glands?

Question #3: What is the true connection to EBV (Epstein-Barr Virus)?

Question #4: Can you Address Food Sensitivities with Hashimoto’s?

Another listener also asked about her experiences with cutting out gluten and dairy and subsequently developed other food sensit...

Previous Episode

067 How Very Healthy Foods can Create Aches, Pain and UTI Symptoms w/ Dr. Beth O’Hara

The Case:

Robin is a 45 year old, super-busy, working mom dealing with aches and pains all over.
She’s also experiencing stomach aches and unexplained bladder issues that include pain and burning during urination without a detectable UTI.
She’s seen specialists, taken antibiotics, and tried eating healthier but her symptoms just got worse.

The Investigation

When I hear that a healthy diet makes someone feel worse, I immediately suspect that the food they are choosing, while healthy on the surface, may not be right for them. This was my suspicion with Robin and I knew it could be one or more of a few things in her diet causing the issue.

I’ve been wanting to invite Dr. Beth O’Hara on the show for a while and I knew this case was right up her alley. Dr. O’Hara is a Functional Naturopath and the owner of Mast Cell 360, a Functional practice specializing in root cause approach to Mast Cell Activation Syndrome, Histamine Intolerance, and related conditions such as oxalates, mold toxicity, and chemical sensitivities. She is a Research Adviser for the Nutrigenetic Research Institute and also works in-depth with genetic analysis.

What are Oxalates?

Plants are made up of compounds and oxalates are one of these compounds. Under a microscope, oxalates appear to look like tiny razor blades - they are very sharp molecules. Certain plants have a high number of these compounds which serve as a defense mechanism for the plant. Foods that we consider to be very healthy, could be high in oxalates like spinach, beets, rhubarb, sweet potatoes, and almonds. Oxalates can also be created by our bodies and some fungal species may create oxalates in the body. While many people are able to metabolize these compounds without any issue, there are also many that may not.

The Risk of Elevated Oxalates in the Body

Some people struggle to process these oxalates and this can be due to many things and the oxalates build up. The immune system wants to get rid of this excess which results in inflammation. Overtime, this can become chronic and cause other health issues including kidney stones. however kidney stones are just the tip of the iceberg and oxalates have also been associated with thyroid issues, autism, endometriosis, bladder issues, vulvodynia, PCOS, diverticulosis/diverticulitis, breast cancer, osteopenia and osteoporosis.

Causes of Elevated Oxalates

One of the causes of elevated oxalates is eating a diet rich in foods with high levels of oxalates. However, there are plenty of people who eat these foods and don’t have an issue. There are a few other factors that can cause elevated oxalates.

Genetics

There are four genetic predispositions that may make someone more susceptible to developing an issue with oxalates.

Vitamin Deficiency

A deficiency in B1 or B6 can cause an issue with oxalates

Leaky Gut

When there is a break in the intestinal lining, oxalates can move into the bloodstream and to muscles, joints and even bone, potentially causing many issues.

Mold Toxicity in the Body

Exposure to mold can result in that mold colonizing in the body, which demands a lot from the immune system and can make it difficult for the body to deal with oxalates. Additionally, its possible the dysbiotic bugs may produce even more oxalates to add to the load.

Symptoms of Elevated Oxalates

Kidney stones are often noted as a key symptom but only 1% of people experience these. More often, it’s seemingly unassociated symptoms that are hard to nail down like fibromyalgia, joint pain, joint issues, visual problems (including cataracts), lung issues (including asthma), vertigo, urinary tract issues (pain and burning during urination as well as urgency that present like UTIs but no infection is present), and vulvodynia (stinging, burning, and irritation of the vulva).

Mast Cell Activation Syndrome

Scientists have been studying Mast Cell Activation Syndrome or MCAS since the 90’s but it has only recently (2016) been given a diagnosis code. As a result, many conventional doctors do not know about it. The immune systems ‘front-line defenders’ are known as Mast Cells. It’s their job to recognize a virus, injury, toxin, or bad bacteria that is threatening the body and mount a defence against it (usually causing inflammation to the area) and then signal the immune system to do its job. However, when there is a chronic issue, like elevated oxalates, the Mast Cells become dysregulated, fail to trigger the immune system and cause MCAS. Mast Cell Activation Syndrome affects an estimated 10 - 17% of the general population and is estimated to impact over 50% of those with chronic illness.

MCAS and Elevated Oxalates

Oxalates...

Next Episode

069 [Ask Inna] More Answers to Your Hashimoto’s Questions (Part 2)

Last week I shared some of the questions you wanted answered about Hashimoto’s. I covered topics like the relationship between heavy metals and Hashimoto’s, the role the adrenals play in Hashimoto’s, the relationship between Epstein-Barr Virus (EBV) and Hashimoto’s and how to reduce the risk for kids of people with Hashimoto’s. All of them were very important questions that have a lot to do with the triggers of Hashimoto’s. If you missed it, here is a link to episode 068.

In this episode, I answer more of your questions about Hashimoto’s.

Question #1: With Hashimoto’s, is TSH a reliable indicator of the body’s thyroid hormone needs? If not, what else can we use to know what the body needs?

This can be very confusing for anyone with Hashimoto’s. The short answer is, no. TSH is not a reliable indicator. The ranges for TSH are very broad (typically between about 4.5 - 5 depending on where you live. This range is not really optimal. The optimal range for TSH is between 1.8-3 (if you’re on thyroid medication this shifts a bit).

But, TSH is only one indicator and you need to look at the big picture including your total T4, free T4, total T3, free T3, and reverse T3. This is because TSH is not actually created in the thyroid - it's the thyroid stimulating hormone created in the pituitary gland. So, only looking at TSH doesn’t tell us which hormones the thyroid is producing and at which ratio. And, it doesn’t tell us how well the body (primarily the liver and the gut) are converting these hormones or how the hormones are actually utilized. Essentially, TSH shows a very very small part of a much bigger picture and that is why its not nearly complete. With Hashimoto’s you also want to track your antibody levels so that you can determine which triggers (listen to episode 068 for more on the four triggers) are affecting you and your levels.

I’ve listed the various tests I recommend to get the whole picture of your thyroid functionality and optimal levels for each in the show notes for episode 027. If you are looking for a lab to do these tests, here is a link to a helpful resource and lab.

I’m in the process of creating my thyroid course which is going to get way more in depth about this and how you can figure out your pattern and exactly what to do about it. The course will launch this fall. Add your name to the wait list if you’d like to be personally invited to join.

Question #2: Why does someone with Hashimoto's feel tired all day long? How can we help this and what can we do to wake up feeling refreshed and have more energy throughout the day?

While Hashimoto’s is an issue, we need to look at the root cause of the fatigue. It’s true that Hashimoto’s causes the immune system to attack the thyroid and often causes hypothyroidism which has a common symptom of fatigue. So, the first step is to make sure that you are supporting thyroid function optimally with what your body needs (foods, supplements or if necessary thyroid medication that is dosed appropriately) and you are also by avoiding Hashimoto triggers (noted in last week’s episode).

If you are doing these things and continue to feel tired, then you may want to consider the role your adrenal glands may be playing in your fatigue. The adrenals and the thyroid are very interrelated. Stress is a key trigger for Hashimoto’s and it can also impact adrenal function.

Clean eating is also recommended but if you continue to feel tired, you may be having some issues with absorption which could be caused by a gut issue. This could be the real cause of the fatigue as well

And finally, check that you are not deficient in nutrients that help us feel more energized like iron, B12 and other B vitamins. As you can see, feeling tired is quite multi faceted so we have to look at it from all angles.

Question #3: My diagnosis of Hashimoto's only came after being on thyroid medication for years. Can this medication be contributing to Hashimoto's?

In my opinion, I don’t think it did. What often happens is that the Hashimoto’s is undiagnosed for many years. Conventional doctors will often stop looking for answers once they diagnose hypothyroidism. So, the Hashimoto’s may have been there or been developing all along. I don’t think that the medication could cause Hashimoto’s because whether you’re ...